Health Information

About Sexual Orientation

It's a natural part of life to have sexual feelings. As people pass from childhood, through adolescence, to adulthood, their sexual feelings develop and change.

During the teen years, sexual feelings are awakened in new ways because of the hormonal and physical changes of puberty. These changes involve both the body and the mind, and teens tend to wonder about new — and often intense — sexual feelings.

It takes time for many people to understand who they are and who they're becoming. Part of that understanding includes a person's sexual feelings and attractions.

The term sexual orientation refers to the gender (that is, male or female) to which a person is attracted. There are several types of sexual orientation that are commonly described:

Heterosexual. People who are heterosexual are romantically and physically attracted to members of the opposite sex: Heterosexual males are attracted to females, and heterosexual females are attracted to males. Heterosexuals are sometimes called "straight."

Homosexual. People who are homosexual are romantically and physically attracted to people of the same sex: Females who are attracted to other females are lesbian; males who are attracted to other males are often known as gay. (The term gay is sometimes also used to describe homosexual individuals of either gender.)

Bisexual. People who are bisexual are romantically and physically attracted to members of both sexes.

Teens — both boys and girls — often find themselves having sexual thoughts and attractions. For some, these feelings and thoughts can be intense — and even confusing or disturbing. That may be especially true for people who are having romantic or sexual thoughts about someone of the same gender. "What does that mean," they might think. "Am I gay?"

Thinking sexually about both the same sex and the opposite sex is quite common as teens sort through their emerging sexual feelings. This type of imagining about people of the same or opposite sex doesn't necessarily mean that a person fits into a particular type of sexual orientation.

Some teens may also experiment with sexual experiences, including those with members of the same sex, during the years they are exploring their own sexuality. These experiences, by themselves, do not necessarily mean that a teen is gay or straight.

Do People Choose Their Sexual Orientation?

Most medical professionals, including organizations such as the American Academy of Pediatrics (AAP) and the American Psychological Association (APA), believe that sexual orientation involves a complex mixture of biology, psychology, and environmental factors. A person's genes and inborn hormonal factors may play a role as well. These medical professionals believe that — in most cases — sexual orientation, whatever its causes, is not simply chosen.

Not everyone agrees. Some believe that individuals can choose who they are attracted to — and that people who are gay have chosen to be attracted to people of the same gender.

There are lots of opinions and stereotypes about sexual orientation. For example, having a more "feminine" appearance or interest does not mean that a teen boy is gay. And having a more "masculine" appearance doesn't mean a girl is lesbian. As with most things, making assumptions just based on looks can lead to the wrong conclusion.

It's likely that all the factors that result in someone's sexual orientation are not yet completely understood. What is certain is that people, no matter their sexual orientation, want to feel understood, respected, and accepted — particularly by their family. That's not always easy in every family.

What's It Like for Gay Teens?

For teens who are gay or lesbian, it can feel like everyone is expected to be straight. Because of this, some gay and lesbian teens may feel different from their friends when the heterosexual people around them start talking about romantic feelings, dating, and sex. They may feel like they have to pretend to feel things that they don't in order to fit. They might feel they need to deny who they are or that they have to hide an important part of themselves.

These feelings, plus fears of prejudice, can lead teens who aren't straight to keep their sexual orientation secret, even from friends and family who might be supportive. Kids and teens who are gay are likely to face people who express stereotypes, prejudices, and even hate about homosexuality.

Coming Out

Some gay or lesbian teens tell a few accepting, supportive friends and family members about their sexual orientation. This is often called coming out. Many lesbian, gay, and bisexual teens who come out to their friends and families are fully accepted by them and their communities. They feel comfortable about being attracted to someone of the same gender and don't feel particularly anxious about it.

But not everyone has the same feelings or good support systems. People who feel they need to hide who they are or who fear rejection, discrimination, or violence can be at greater risk for emotional problems like anxiety and depression.

Some gay teens without support systems can be at higher risk than heterosexual teens for dropping out of school, living on the streets, using alcohol and drugs, and even in some cases for attempting to harm themselves.

These difficulties are thought to happen more frequently not directly because they are gay, but because gay and lesbian people are more likely to be misunderstood, socially isolated, or mistreated because of their sexual orientation.

This doesn't happen to all gay teens, of course. Many gay and lesbian teens and their families have no more difficulties during the teen years than anyone else.

The Importance of Talking

No matter what someone's sexual orientation is, learning about sexuality and relationships can be difficult for a teen to come to terms with. It can help a teen to talk to someone about the confusing feelings that go with growing up, whether it's a parent, another family member, a close friend or sibling, or a school counselor. It's not always easy for a teen to find somebody to talk to, but many of them find that confiding in someone they trust and feel close to, even if they're not completely sure how that person will react, turns out to be a positive experience.

In many communities, resources such as youth groups composed of teens who are facing similar issues can provide opportunities for people to talk to others who understand. Psychologists, psychiatrists, family doctors, and trained counselors can help teens cope — confidentially and privately — with the difficult feelings that go with their developing sexuality. These experts can also help teens to find ways to deal with any peer pressure, harassment, and bullying they may face. They can also help parents manage any complicated feelings they may be having as they come to terms with their teen's sexuality.

Whether gay, straight, bisexual, or just not sure, almost all teens have questions about reaching physical maturity and about sexual health (for example, avoiding sexually transmitted diseases). Because these can be difficult topics, it's especially important for gay and lesbian teens to find someone knowledgeable who they can trust and confide in.

Parents can help by becoming more knowledgeable about issues of sexuality — and learning to be more comfortable discussing them. Parents also can help their teen gain access to a doctor or health professional who will provide reliable health advice.

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